45D2106063 CLIA NUMBER - CONNALLY MEMORIAL MEDICAL CENTER, NORTH CAMPUS

Laboratory Demographics

CLIA Number: 45D2106063

Facility Name: CONNALLY MEMORIAL MEDICAL CENTER, NORTH CAMPUS

Facility Address:
6511 US HIGHWAY 181 N
FLORESVILLE, TX
ZIP 78114
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Facility Phone Number: 830 393-1422

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1659812725

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2106063
LAB Type	Rural Health Clinic
Facility Name	CONNALLY MEMORIAL MEDICAL CENTER, NORTH CAMPUS
Street	6511 US HIGHWAY 181 N
City	FLORESVILLE
State	TX
ZIP	78114
Phone	830 393-1422
CertificateType	4
CertificateEffectiveDate	12/9/2023
CertificateExpirationDate	12/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024